All kinds of tremors stop only in a dream. There are two main types of it - physiological and pathological tremor.
PHYSIOLOGICAL TEMOR
Happens to every healthy person. For example, with severe anxiety and fear, as a result of the interaction of the central and peripheral neurophysiological processes, repeated contractions and relaxation of the muscles occur. Such a tremor, as a rule, is invisible from the outside and is not felt by the person himself. With muscle tension, fatigue, cooling, or emotional arousal, the tremor can become stronger and become noticeable - it is called an intensified physiological tremor. It has a large amplitude, but the same frequency as the simple physiological one.
PATHOLOGICAL TREATMENT
It occurs with various diseases and is visible to the naked eye. It has a number of features. The basis of the clinical analysis of tremor is the determination of the conditions in which it manifests itself.
THE TREMOR OF POST
Occurs at the moment when the muscles are relaxed and do not make active movements. Strengthens with agitation and mental tension, can decrease with active voluntary movements of the limb involved in the tremor. This type of tremor is most typical for parkinsonism.
TREMOR OF ACTION
Any tremor that occurs with an arbitrary contraction of muscles. It includes postural, isometric and tremor motion (kinetic).
Postural tremor occurs against the backdrop of active muscle tension while maintaining the posture, as opposed to the force of gravity. It can be of a benign nature and can be a manifestation of heredity. May mean increased anxiety, occur when a thyroid gland is affected. Tremor of this species can also trigger abstinence (breakage) as a result of consuming large doses of alcohol or drugs. When an overdose of certain drugs or poisoning with chemicals can also occur sudden tremor, for example, when poisoning with salts of heavy metals (mercury). The postural tremor of the upper and lower extremities is best noted when the patient pulls both hands forward and tries to spread his fingers - this is the task that the neuropathologist doctor gives to the patient during the examination.
Isometric tremor occurs when the muscles work, when their action is directed against a stationary object (for example, when a person leans his hands on a table).
Kinetic tremor occurs during an arbitrary movement. His variant is a kinesi-specific tremor only with certain actions (by writing, performing some professional function), but not with other movements involving the same muscles.
The type of tremor, its distribution, severity, age of onset and other characteristics form a trembling syndrome. Establishing the latter is important for determining the correct treatment tactics.
There are several tremor syndromes of the upper and lower extremities. The most frequent is the essential one. Usually manifested by postural trembling of the hands, often in combination with tremor of the head, lips, vocal cords, legs, diaphragm. More than half of the patients have hereditary benign disease, which does not require special treatment. With significant jitter, the doctor usually prescribes propranolol or primidone.
Parkinsonian tremor often manifests itself as a tremor of rest or its combination with a tremor of actions. In typical cases, hands are involved, slowness, difficulty in movement is observed. Parkinsonian tremor can decrease under the influence of dopaminergic drugs (levodopa preparations, dopamine agonists), anticholinergics.
In cerebellum tremor, predominantly intentional, large-scale tremor occurs, sometimes accompanied by a postural tremor of the upper and lower extremities. In cerebellar pathologies, there is the possibility of various clinical forms of jitter (for example, rhythmic postural tremor of the head and trunk - tituration). The greatest fear is the kind of tremor called asterixis, the movements of the hands at which resemble the flapping of wings. It can arise from Wilson-Konovalov's disease (a serious hereditary disease associated with the accumulation of copper in the brain, blood and liver tissues), hepatic or renal insufficiency, and damage to the midbrain. When the cerebellum tremor is affected, many neurotransmitter systems, in connection with which the selection of treatment is difficult.
The tremor of Holmes is characterized by an original combination of tremor of rest and tremor of actions. Usually it is peculiar to sharply increase when trying to keep the limb in the balance. The gross, large-scale trembling of the arms, legs, and trunk is often interrupted by a variety of twitches. The tremor of Holmes often occurs after vascular defeat, with multiple sclerosis and some other diseases. Treatment is problematic, in some cases, drugs levodopa, anticholinergics, valproate, propanolol.
PSYCHOLOGICAL FORMS OF TREEMOR
They have different clinical manifestations, an unusual combination of types of trembling (most often limbs). The tremor begins suddenly and stops just as abruptly. If you divert the attention of the patient, the tremor decreases. It is necessary to consult a therapist and prescribe anti-anxiety, sedatives.
Medication and toxic tremor can be caused by a variety of substances. The most typical tremor, which is close in a number of its characteristics to the enhanced physiological tremor. It can occur after the application of sympatho-mimetics (ephedrine) or antidepressants (amitriptyline). Parkinson-like tremor is possible after treatment with neuroleptic or other antidopaminergic drugs (reserpine, flunarizine). Intensive tremor can be facilitated by the use of lithium salts and some other drugs. Tremor, which occurs after acute alcoholic or narcotic poisoning, must be distinguished from tremor in chronic alcoholism associated with cerebellar involvement.
The described tremor syndromes of the upper and lower extremities do not exhaust the whole variety of clinical variants. There are such unusual combinations that it is not immediately possible to assign them to any category. This causes the inadmissibility of self-treatment and the need to consult a doctor for examination and selection of treatment.
In those cases when the effect of medicines in the treatment of tremor of the upper and lower extremities is insufficient, stereotactic operations on the brain are used. Such operations are performed by neurosurgeons of the RNPC of Neurology and Neurosurgery. The successes achieved in the study of tremor, the appearance of new medicines can help an increasing number of patients and look to the future with optimism.